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Quality Indicators Used to Measure Adherence to Standards of Breast Cancer Care |
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| Type of Quality Indicator |
n |
Extent of scientific development as a quality measure* |
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|
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| Diagnosis |
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| Appropriate use of imaging, sampling (fine-needle or biopsy) within given time-frame |
8 |
IV |
| Adequacy of fine-needle biopsy samples |
1 |
IV |
| Receipt of frozen section of primary operable BC |
1 |
IV |
| Quality of surgical technique, sampling nodes |
2 |
IV |
| Quality of hormone receptor assay |
1 |
IV |
| Quality of life and patient satisfaction relating to diagnosis |
2 |
Iac |
| Appropriate referral to surgeon |
2 |
IV |
| Appropriate (timely) attendance at assessment centre, specialist appointment, surgery, receipt of information by patient |
5 |
IV |
| Efficient diagnosis (few visits to hospital) |
1 |
IV |
| Appropriate evaluation vis a vis guidelines, or at first visit |
2 |
IV |
| Appropriate specialist knowledge of surgeons |
1 |
IV |
| Treatment |
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| Appropriate surgical choices – breast conserving, mastectomy, lymph node dissection |
7 |
IV |
| Timely admission for therapeutic surgery |
1 |
IV |
| < 3 operations for breast-conserving surgery |
1 |
IV |
| Evidence of discussion of surgical options |
1 |
IV |
| Appropriate use, timeliness of initial radiotherapy |
6 |
IV |
| Quality of radiotherapy planning, fractionation, radiation field distribution |
7 |
IV |
| Regional recurrence |
1 |
IV |
| Appropriate use of radiotherapy for regional recurrence, palliation |
1 |
IV |
| Appropriate use (or not) of adjuvant systemic therapy |
23 |
IV |
| Chemotherapy quality of administration – dosages and availability of procedure manual |
2 |
IV |
| Quality of life, satisfaction with treatment |
6 |
Ia, Iac |
| Participation in decision-making, receipt of sufficient information re. treatment |
2 |
IV |
| Qualifications of doctors |
2 |
IV |
| Appropriate referrals to specialists |
2 |
IV |
| Appropriate treatment choices, sequences |
5 |
IV |
| Followup |
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| Appropriate followup mammography, use of guidelines |
2 |
IV |
| Recurrence within 5 years |
2 |
IV |
| Appropriate use of prophylactic radiotherapy in women with high risk of flap recurrence |
1 |
IV |
| Reporting/Documentation |
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| Pathology reporting/documentation |
42 |
IV |
| Imaging reporting/documentation – size of mammographic abnormality |
1 |
IV |
| Chemotherapy reporting/documentation |
2 |
IV |
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n = number of different quality indicators regarding this type; *extent of scientific development of quality indicator: Level Ia = pre-study data indicating consistently sound psychometric properties; Iac = pre- and on-study data indicating consistently sound psychometric properties; IV = no pre- or on-study psychometric data | ||
Schachter et al. BMC Cancer 2006 6:291 doi:10.1186/1471-2407-6-291 |
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